July 19, 2022

What are kidney stones (nephrolithiasis)?

Nephrolithiasis is characterized by the presence of stones in the upper urinary tract. Stones are made up of crystals that are naturally present in the urine.The stone can be located in the calyx of the kidney, in the pelvis of the kidney or occupy the pelvis and calyces (coral lithiasis). When it is in a calyx it is usually asymptomatic.When it is in the pelvis, it blocks the exit of urine from the kidney to the ureter, resulting in the accumulation of urine under pressure inside the kidney. This condition (increased intrarenal pressure) is manifested by renal colic which is also the main symptom of nephrolithiasis.Renal colic is a severe and excruciating pain in the region of the kidney, which is not relieved by almost any painkiller and is accompanied by flatulence, tendency to vomit and sometimes vomiting. Treatment is conservative or invasive and depends on the shape, size, weight, composition of each stone and the damage it has caused to the kidney. 

What is the appropriate treatment to treat? 

The non-invasive options we have to deal with kidney stones are: 

-Monitor when these are small under 1cm in size and not causing obstruction 

or symptoms. This approach is for patients with good follow-up compliance. 

-Extracorporeal lithotripsy Stones up to 1.5 cm are candidates for extracorporeal lithotripsy, a painless method without the need for anesthesia and non-invasive with high stone breakage rates recorded. Targeting of the stones is done by fluoroscopy or with the help of ultrasound. The disadvantage of the method is that hard and large stones usually do not respond and that it cannot usually be repeated more than three times to avoid kidney damage. If ESWL is not effective then we proceed to endoscopic – minimally invasive methods.